The Use of Age-Specific Reference Ranges for Serum Prostate Specific Anitgen in Men 60 years Old or Older
1995; Lippincott Williams & Wilkins; Volume: 153; Issue: 4 Linguagem: Inglês
10.1016/s0022-5347(01)67538-4
ISSN1527-3792
AutoresJoseph E. Oesterling, Steven J. Jacobsen, William H. Cooner,
Tópico(s)Prostate Cancer Treatment and Research
ResumoNo AccessJournal of UrologyClinical Urology: Original Article1 Apr 1995The Use of Age-Specific Reference Ranges for Serum Prostate Specific Anitgen in Men 60 years Old or Older Joseph E. Oesterling, Steven J. Jacobsen, and William H. Cooner Joseph E. OesterlingJoseph E. Oesterling , Steven J. JacobsenSteven J. Jacobsen , and William H. CoonerWilliam H. Cooner View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67538-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Several investigations have determined that the serum prostate specific antigen (PSA) concentration is dependent upon patient age and, as a result, reference ranges wider than 0.0 to 4.0 ng./ml. have been suggested for men 60 years old or older. To determine the clinical usefulness of the age-specific reference ranges--0.0 to 4.5 ng./ml. for men 60 to 69 years old and 0.0 to 6.5 ng./ml. for men 70 years old or older--the medical records of 2,988 men 60 years old or older who presented to a single urological practice were examined. All patients were evaluated with a serum PSA determination, digital rectal examination and transrectal ultrasound. A total of 1,686 prostate biopsies was performed (biopsy rate 56 percent) and 608 cancers were diagnosed (cancer detection rate 20 percent). By using the age-specific reference ranges as compared to the 0.0 to 4.0 ng./ml. reference range, the sensitivity of PSA for detecting early prostate cancer decreased by 9 percent, while the specificity and positive predictive value increased by 11 percent and 5 percent, respectively. If the age-specific reference ranges had been used 92 prostate biopsies (5.5 percent) performed could have been avoided, while 19 men in the study population (0.6 percent) would not have had prostate cancer diagnosed. Of the nondetected cancers 13 (67 percent) occurred in men 70 years old or older and 18 (95 percent) were small tumors of favorable pathological status unlikely to be of clinical consequence in these older men. These preliminary findings support the clinical usefulness of the wider age-specific reference ranges in men 60 years old or older. A prospective randomized clinical trial is currently underway to confirm the appropriateness of age-specific reference ranges compared to the reference range of 0.0 to 4.0 ng./ml. References 1 : Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J. Urol.1991; 145: 907. Link, Google Scholar 2 : The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J. Urol.1992; 147: 817. part 2. Link, Google Scholar 3 : Serum PSA adjusted for volume of transition zone (PSAT) is more accurate than PSA adjusted for total gland volume (PSAD) in detecting adenocarcinoma of the prostate. Urology1994; 43: 601. Google Scholar 4 : Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. J.A.M.A.1992; 267: 2215. Google Scholar 5 : Longitudinal changes in serum PSA (PSA velocity) in a community-based cohort of men. J. Urol.1993; 149: 412A. part 2, abstract 799. Google Scholar 6 : A complex between prostate-specific antigen and alpha 1-antichymotrypsin is the major form of prostate-specific antigen in serum of patients with prostatic cancer: assay of the complex improves clinical sensitivity for cancer. Cancer Res.1991; 51: 222. Google Scholar 7 : Prostate-specific antigen in serum occurs predominantly in complex with alpha 1-antichymotrypsin. Clin. Chem.1991; 37: 1618. Google Scholar 8 : Serum prostate-specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges. J.A.M.A.1993; 270: 860. Google Scholar 9 : Influence of patient age and the serum PSA concentration. An important clinical observation. Urol. Clin. N. Amer.1993; 20: 671. Google Scholar 10 : Relationship between prostate specific antigen, prostate volume and age in the benign prostate. Brit. J. Urol.1993; 71: 445. Google Scholar 11 : Prostate specific antigen levels in men older than 50 years without clinical evidence of prostatic carcinoma. J. Urol.1993; 150: 1837. Link, Google Scholar 12 Crawford, E. D.: Report on the 1993 Prostate Cancer Awareness Week. Read at annual meeting of American Urological Association, San Francisco, California, May 14-19, 1994. Google Scholar 13 : Age corrected prostate specific antigen in symptomatic benign prostatic hyperplasia. J. Urol.1994; 151: 312A. part 2, abstract 337. Google Scholar 14 Oesterling, J. E., Kumamoto, Y., Tsukamoto, T., Girman, C. J., Guess, H. A., Masumori, N., Jacobsen, S. J. and Lieber, M. M.: Serum prostate-specific antigen in a community-based population of healthy Japanese men: lower values than for similarly aged Caucasians. Brit. J. Urol., in press. Google Scholar 15 : Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J. Urol.1974; 111: 58. Abstract, Google Scholar 16 : Observations on the doubling time of prostate cancer. The use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer1993; 71: 2031. Google Scholar 17 : Watchful waiting for early stage prostate cancer. Urology1994; 43: 138. Google Scholar 18 : A decision analysis of alternative treatment strategies for clinical localized prostate cancer. J.A.M.A.1993; 269: 2650. Google Scholar 19 : Management of clinically localized prostatic cancer. An unresolved problem. J.A.M.A.1993; 269: 2676. Google Scholar 20 : Results of conservative management of clinically localized prostate cancer. New Engl. J. Med.1994; 330: 242. Google Scholar Departments of Urology and Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota and Section of Urology, Emory Clinic, Atlanta, Georgia.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byParekh D, Ankerst D, Troyer D, Srivastava S and Thompson I (2018) Biomarkers for Prostate Cancer DetectionJournal of Urology, VOL. 178, NO. 6, (2252-2259), Online publication date: 1-Dec-2007.TÓTH G, LENGYEL Z, BALKAY L, SALAH M, TRÓN L and TÓTH C (2018) DETECTION OF PROSTATE CANCER WITH 11C-METHIONINE POSITRON EMISSION TOMOGRAPHYJournal of Urology, VOL. 173, NO. 1, (66-69), Online publication date: 1-Jan-2005.KARAZANASHVILI G and ABRAHAMSSON P (2018) Prostate Specific Antigen and Human Glandular Kallikrein 2 in Early Detection of Prostate CancerJournal of Urology, VOL. 169, NO. 2, (445-457), Online publication date: 1-Feb-2003.POTTS J (2018) PROSPECTIVE IDENTIFICATION OF NATIONAL INSTITUTES OF HEALTH CATEGORY IV PROSTATITIS IN MEN WITH ELEVATED PROSTATE SPECIFIC ANTIGENJournal of Urology, VOL. 164, NO. 5, (1550-1553), Online publication date: 1-Nov-2000.ROBERTS R, BERGSTRALH E, PETERSON N, BOSTWICK D, LIEBER M and JACOBSEN S (2018) POSITIVE AND NEGATIVE BIOPSIES IN THE PRE-PROSTATE SPECIFIC ANTIGEN AND PROSTATE SPECIFIC ANTIGEN ERAS, 1980 TO 1997Journal of Urology, VOL. 163, NO. 5, (1471-1475), Online publication date: 1-May-2000.BRAWER M, CHELI C, NEAMAN I, GOLDBLATT J, SMITH C, SCHWARTZ M, BRUZEK D, MORRIS D, SOKOLL L, CHAN D, YEUNG K, PARTIN A and ALLARD W (2018) COMPLEXED PROSTATE SPECIFIC ANTIGEN PROVIDES SIGNIFICANT ENHANCEMENT OF SPECIFICITY COMPARED WITH TOTAL PROSTATE SPECIFIC ANTIGEN FOR DETECTING PROSTATE CANCERJournal of Urology, VOL. 163, NO. 5, (1476-1480), Online publication date: 1-May-2000.Borer J, Sherman J, Solomon M, Plawker M and Macchia R (2018) AGE SPECIFIC PROSTATE SPECIFIC ANTIGEN REFERENCE RANGES: POPULATION SPECIFICJournal of Urology, VOL. 159, NO. 2, (444-448), Online publication date: 1-Feb-1998.Bangma C, Rietbergen J, Kranse R, Blijenberg B, Petterson K and Schroder F (2018) The Free-To-Total Prostate Specific Antigen Ratio Improves the Specificity of Prostate Specific Antigen in Screening for Prostate Cancer in the General PopulationJournal of Urology, VOL. 157, NO. 6, (2191-2196), Online publication date: 1-Jun-1997.Higashihara E, Nutahara K, Kojima M, Okegawa T, Miura I, Miyata A, Kato M, Sugisaki H and Tomaru T (2018) Significance of Serum Free Prostate Specific Antigen in the Screening of Prostate CancerJournal of Urology, VOL. 156, NO. 6, (1964-1968), Online publication date: 1-Dec-1996.Colombo T, Zigeuner R, Altziebler S, Pummer K, Stettner H and Hubmer G (2018) Effect of Extracorporeal Shock Wave Lithotripsy on Prostate Specific AntigenJournal of Urology, VOL. 156, NO. 5, (1682-1684), Online publication date: 1-Nov-1996.Theodorescu D (2018) Editorial: Prostate Cancer–Our Patients' QuestionsJournal of Urology, VOL. 155, NO. 5, (1661-1662), Online publication date: 1-May-1996.Partin A, Criley S, Subong E, Zincke H, Walsh P and Oesterling J (2018) Standard Versus Age-Specific Prostate Specific Antigen Reference Ranges Among Men With Clinically Localized Prostate Cancer: A Pathological AnalysisJournal of Urology, VOL. 155, NO. 4, (1336-1339), Online publication date: 1-Apr-1996. Volume 153Issue 4April 1995Page: 1160-1163 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Joseph E. Oesterling Requests for reprints: The Michigan Prostate Center, Section of Urology, The University of Michigan, 1500 East Medical Center Dr., Ann Arbor, Michigan 48109. More articles by this author Steven J. Jacobsen More articles by this author William H. Cooner More articles by this author Expand All Advertisement PDF downloadLoading ...
Referência(s)